Active NPI
Amber Rae Halverson, APRN-CNP
- Gerontology Nurse Practitioner
- Minnetrista, MN
National Provider Identifier
1144716697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 5935
- Practice address
- 5520 Ridgewood CV
Minnetrista, MN 55364-8239 - Phone
- (800) 873-0561
- NPI assigned
- Jul 9, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5935 | MN | |
| Gerontology Nurse Practitioner | 363LG0600X | 5935 | MN | Primary |
Addresses
Primary practice location
5520 Ridgewood CV
Minnetrista, MN 55364-8239
Mailing address
5520 Ridgewood CV
Minnetrista, MN 55364-8239
Phone (800) 873-0561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 22, 2025 through Jul 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531094400000",
"number": "1144716697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5520 RIDGEWOOD CV",
"city": "MINNETRISTA",
"state": "MN",
"postal_code": "553648239",
"telephone_number": "800-873-0561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5520 RIDGEWOOD CV",
"city": "MINNETRISTA",
"state": "MN",
"postal_code": "553648239",
"telephone_number": "800-873-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVERSON",
"first_name": "AMBER",
"middle_name": "RAE",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-09",
"last_updated": "2018-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MN",
"license": "5935",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MN",
"license": "5935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minnetrista, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.